http://azstarnet.com/news/opinion/editorial/article_a1372367-3bd9-5f49-8ea7-91fb0d25e4df.html

Local pyschiatric beds are commonly filled, but I wasn’t aware that psychiatric beds in our prison system are also filled.  Hummmmmm, I wonder what’s going on? Is it possible that we’re starting to see the results of continued budget slashes to mental health care in our state?  Or, is it because more people are becoming mentally ill? I think it’s the former.

Let’s look at some statistics.  One in four families are effected by mental illness in a given year and at least 10% of the population lives with a serious mental illness like schizophrenia or bi-polar disorder.  If Tucson’s population is one million, then that’s 100,000 people right here in the Old Pueblo.  Some are being successfully treated and some are not.  Many are in denial about their illnesses and don’t know about the high success rates of treatment – sometimes as high as 90%  do achieve mental health recovery.  But, not without proper treatment that can include medication, therapy and a strong support system.

Last time I checked there weren’t that many psychiatric beds in Tucson.  Even with the new psychiatric crisis hospital opening soon there won’t be new beds as it will only replace the currently existing beds at UPH.  Without more funding I don’t see any growth for new tratment facilites, but unfortuanately I do see growth in the prison facilities.  It seems like that’s one of the few areas of growth in our state.  Some legislators in Phoenix have stated that it’s time for families and loved ones to “step up” and take care of those struggling with menta illness. I wish it were that simple.

But, I’m glad to see that the Arizona Daily Star is initiating this dialogue.  Hopefully some inovative solutions will come about…….and they won’t cost anything!

So, even if President Reagan was a great man, it was during his presidency that treatment for our nations most vulnerable went from bad to worse.  The following article is a reprint because I found it expresses my concerns adequately and one month after the horrible shootings in Tucson, people seem to be more receptive to learning about this issue.

Ronald Reagan, Mental Health, and Spin . . .

Man Behind the Myth

By Phyllis Vine

For the next twelve months, the Ronald Reagan image machine will be turning out countless vignettes of the nation’s 40th president, the man neighbors called “Dutch.” He will be described as no-nonsense yet kindly, remote but avuncular, a movies-star-turned-politician, and remembered as a local lifeguard rescuing people in troubled waters. With dashing good looks, a sonorous tone that became the voice of General Electric, and an affable smile, even those who disagreed with his policies will say he was genuinely kind-hearted.

So what did this mean practically for policies about mental health? Here we need to  ask how the image departs from the reality.

Contrary to the spin about trimming government, which he called “the problem,” we all know he oversaw increases in federal spending that exploded the national debt, and grew the size of the government he impugned. Another part of the reality, rarely the image, is how he attempted to savage the  entitlement system and roll back supports for people with a mental illness.

When Ronald Reagan arrived in Washington, he inherited the Mental Health Systems Act of 1980. One of the last achievements of Pres. Jimmy Carter, this was passed by the House 277 to 15, in the Senate, 93 to 3. With as many critics as there were special interests, it was far from perfect. Yet it expanded the federal government’s commitment to services, to research, to training professionals, and to patient rights. It identified stigma as an impediment to seeking and receiving services.  It established parity in Medicaid and Medicare. It recognized the link between physical health and mental health. And it dedicated $800 million over 4 years to redress the gross neglect of the commitment to mental health in earlier administrations.  In short, it moved an agenda that minimized homelessness, the reliance on expensive nursing homes, jails and prisons, and one that to more hopeful choices for those who needed help.

The Mental Health Systems Act was a milestone. It came on the heels of four years of hearings and a presidential task force benefiting from First Lady Rosalynn Carter’s active involvement.  Philosophically it affirmed Pres. John F. Kennedy’s Community Mental Health Centers, an attempt to thwart hospitalizations. It fit into the safety-net values championed by Pres. Lyndon B. Johnson with the passage of Medicaid and Medicare.

Still, by 1980 the nation needed more for those with a chronic illness. Many failures accompanied the attempts to close the miserable hospitals, often little more than warehouses, to help patients succeed in the community. The neglect of government support conspired to form a patchwork system with notable gaping holes. A 1977 GAO report said, “Government needs to do more.”  Congressional hearings in 1979 re-affirmed the need to strengthen impoverished services and the failed policies.

Although not perfect, the Mental Health Systems Act responded to these problems. For the first time since the National Institute of Mental Health became part of NIH in 1949, mental health was front and center in federal policy.

Then came Ronald Reagan. Within a month, the Office of Management Budget announced it would curtail the budget of the National Institute of Mental Health (NIMH), phase out training of clinicians, interrupt research, and eliminate services.  Cutbacks to staff followed; chaos ensued. Experienced people left, others remained in government service but were forced into menial jobs. Trained professionals were reassigned to labs to dissect dead rats; science writers were reassigned to typing pools. The Mental Health Systems Act would disappear. Instead, the Omnibus Budget Reconciliation Act (1982) would merge money for mental health programs into block grants, and with fewer dollars going to the states.  They had the discretion to use them however they saw fit, often to perpetuate programs already deemed problematic. The pretense for all this was the president’s concept of a “new federalism.”

“Many of our dreams were gone,” wrote Rosalynn Carter in Helping Someone with Mental Illness. “It was a bitter loss.”

This could have been enough, but it was not. Pres. Reagan attempted to restrict criteria for determining eligibility for SSI, thought to be a safety-net. Nearly 2.6 million people were receiving insurance because their disability prevented them from working. New evaluations for eligibility led to widespread terminations. Of those who were terminated, about half appealed, and in two-thirds of the cases, administrative law judges reversed the decision. The process took nearly a year, during which time they, and their families, were deprived of promised help.

About 340,000 people would lose their insurance before public outcry and courts halted the process. Sen. John Heinz, a liberal Republican from Pennsylvania, told the New York Times the policy was a “meat grinder.” Sen. Carl Levin, Michigan Democrat, said the reviews caused “unconscionable suffering.” In June 1983 HHS Secretary Margaret Heckler announced she would halt suspending about 135,000 people until the government could improve standards for “functional psychotic disorders.”

By then, however, the nation was doubting the president’s kindness. A1982 Louis Harris survey found nearly three-quarters of the respondents said the president was hard-hearted toward the poor.

These are the facts. And they add up to a roll-back of opportunities for people already struggling with a psychiatric illness.  Whatever spin accompanies the birthday celebrations for Ronald Reagan, we should not create yet another mythic figure, larger than life, more pure than Ivory soap, or with qualities he did not have.  He may have portrayed himself as everybody’s lifeguard, but he seemed willing to let people with a psychiatric illness sink.

Originally appeared in MIWatch.org

In response to this public discussion and request for education, Community Partnership of Southern Arizona (CPSA) has partnered with the Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS) and the National Council for Community Behavioral Healthcare (National Council) to launch a statewide, extensive training campaign in Mental Health First Aid.

“People in our community want to take positive action after this tragedy,” said Neal Cash, President and CEO of CPSA. “Learning more about mental health and how to recognize and respond to possible problems is one way of doing that, one that could be of long term benefit to everyone in our community.”

Mental Health First Aid is a novel, evidence-based public education program. The program teaches average people a five-step process to assess a situation, select and implement appropriate interventions, and help a person in crisis or who may be developing the signs and symptoms of mental illness. The groundbreaking training equips people to provide initial help until appropriate professional, peer or family support can be engaged. Participants also learn about risk factors and warning signs of specific illnesses such as anxiety, depression, psychosis and addiction.

“None of us should underestimate the importance of early identification and intervention with an emerging mental health or substance abuse problem,” said Laura Nelson, M.D., Deputy Director at ADHS/DBHS. “Just as with diabetes or high blood pressure, the earlier the problem is recognized and addressed, the better the outcomes can be. It is also true that people who know the individual best can recognize the early signs and symptoms and can help that person get the treatment and support they may need.”

CPSA has been involved with Mental Health First Aid since 2009 and is now working to expand program offerings in the state.

CPSA will host an Instructor Training, conducted by the National Council, to increase the number of certified instructors who can offer the program throughout Arizona. The Instructor Training takes place the week of February 28-March 4, 2011. CPSA and the other Tribal and Regional Behavioral Health Authorities from around the state will identify thirty (30) future instructors to participate in this event.

The National Council has worked closely with CPSA and ADHS/DBHS to quickly mobilize its nationwide resources to support the Arizona trainings.

”People in the family or community often don’t connect a person with mental illness to care because they don’t know how,” said Linda Rosenberg, President and CEO of the National

Council. “Mental Health First Aid teaches people how to offer concrete help. This early intervention can prevent tragic consequences and save lives.”

CPSA will offer a Mental Health First Aid training in early March for organizations and individuals most affected by the events of January 8. CPSA and the National Council will provide instructors for these sessions.

CPSA also will schedule trainings that will be open to the general public. For information, see the CPSA Web site at www.cpsa-rbha.org, call (520) 618-8860 or e-mail Prevention@cpsa-rbha.org.

CPSA, founded and based in Tucson, has overseen publicly funded behavioral health services in Pima County since 1995 and currently serves close to 30,000 members. CPSA receives funding from ADHS/DBHS, the Arizona Health Care Cost Containment System (AHCCCS), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Resources for mental health and trauma issues
following the January 8 shootings

• Tucson Tragedy Support Line: (520) 284-3517, available at no cost to anyone in Pima County who is struggling to deal with these events, or who wants information on how to help themselves or others cope. Staff at this number also will provide referrals to community behavioral healthcare providers and other services such as help coping with trauma and help talking with children and teens about tragedy.
• CPSA Web site (www.cpsa-rbha.org), including links to information from trusted sources on how to talk with children and teens about a tragedy, self-care in the wake of trauma and related topics.
• Community-Wide Crisis Line: (520) 520-622-6000 or 1-800-796-6762. Available 24/7 for anyone having a behavioral health crisis. Hearing impaired individuals may call the Crisis TTY Line at 520-284-3500 or 1-888-248-5998.
• Walk-in behavioral health crisis services: SAMHC, 2502 N. Dodge Blvd. (enter from Flower Street, which is parallel with and just north of Grant Road). If possible, please call the Community-Wide Crisis Line before going to SAMHC.

ADHS/DBHS and Magellan Health Services of Arizona have established a hotline for people outside of Pima County who need help in dealing with this tragedy: 1-800-203-CARES (1-800-203-2273).

An additional resource for people who are concerned about their own or someone else’s mental health is the “Mental Health Checklist” on ADHS/DBHS’ Web site, www.azdhs.gov

Contact: Steve Vetzner, (703) 797-2588 or svetzner@mentalhealthamerica.net

ALEXANDRIA, Va. (January 10, 2011)—Mental Health America joins Americans in mourning the loss of those killed in Saturday’s tragic and senseless attack and expressing our wishes for the full recovery of Congresswoman Gabrielle Giffords and fellow citizens who were injured. Our thoughts and prayers are with the families and loved ones of those who lost their lives and everyone who is affected by these horrific events. And we join in applauding the brave actions of individuals who prevented greater harm.

It will likely take many days to understand the reasons and motivations behind this national tragedy. Many have pointed to mental health as an issue.

It must first be emphasized that people with mental health conditions are no more likely to be violent than the rest of the population. And we have science-based methods to successfully treat persons with even the most severe mental illnesses. A very small group of individuals with a specific type of mental health symptoms are at greater risk for violence if their symptoms are untreated.

At the same time, we must recognize that the nation’s mental health system is drastically under-funded and fails to provide Americans living with mental health conditions with the effective community-based mental health services they need. Sadly, in the current environment of strained state budgets, mental health services have been cut drastically just as demand for these critical services has risen dramatically.

It is also important that, as a community, we assist persons with signs and symptoms of mental illnesses to seek treatment. Although rare, when a person becomes so ill that he/she is a danger to themselves or others state laws provide a way to get them help even if they don’t believe that they need it. The best strategy, however, is to have an accessible system of care that is easy to use.

Science has not developed tools to predict reliably individuals at risk for violence. But we can reduce the small risk of violence in those with certain mental health conditions by investing in proven intensive, coordinated community-based mental health services and making certain that they can access these services.

We do not know if the mental health system failed in this situation or if there were missed opportunities or if effective treatment might have averted this tragedy.

We do hope that we can find answers and create solutions that prevent this from ever happening again.

Mental Health America (www.mentalhealthamerica.net) is the country’s leading nonprofit dedicated to helping all people live mentally healthier lives. With our century of service to America and our more than 300 affiliates nationwide, we represent a national movement that promotes mental wellness for the health and well-being of the nation— everyday and in times of crisis.

As a mental health advocate and person who is currently educating high school kids about depression and suicide prevention my initial thoughts (after my shock and sadness) about the gunman was that he must be mentally ill, and as most of you know I am passionate about people receiving proper care for mental illness and reducing the stigma surrounding these issues.  So, initially I was going to write this blog about just that, the inequalities of the treatment of people with mental illness and the shortcomings of the system, but as the weekend progressed I have been struck more by the calls for compassion and the need to temper the on-going bitterness and hate filled rhetoric that seems to be all too prevalent in our society.

Some blame it on the media, some blame it on the Internet and some blame it on dysfunctional family environments.  All I know is that I don’t think this is the time nor place to start placing blame and focusing anger on anyone or any one entity.  If  anything, now is the time for us to focus on restoring Peace, Love and Harmony to society.

Yes, some will think I’m an idealist with no grasp of reality, but it is reality that motivates me to wish and pray for more compassion and tolerance in our world.  There is darkness, but just the light of one small match can illuminate a room.  I think we all have the potential, no the responsibility as humans to be a positive force. I don’t know of any situation where more violence and hate can solve a problem.

Hopefully this senseless tragedy that happened in my home town yesterday will be a catalyst to help us to find our way back to the loving and kind humans were are meant to be.  As mental health advocates teach in Crisis Intervention Training, rather than escalating the situation, let’s try and de-escalate and bring reason and calmness to the situation.

Congresswoman Giffords has the skill to do just that.  I witnessed her ability to reason and respectfully disagree with irate, inflamed constituents at town hall meetings over the last year.  Gabe Zimmerman, her now deceased aid, was a master at conveying how important the well being of our community was to him.  When Congresswom Giffords was unable to attend some of the mental health community events she was invited to, Gabe provided the same kind of support and understanding that she would  have.

In memory of Gabe and the others that died yesterday and out of respect for Congresswoman Giffords, I think it could be a new day for our country if we focus on the healing rather than the negativity.

According to recent press releases, Brewer’s involvement in state politics started with her activism pushing better treatment and care for our state’s seriously mentally ill population.  Her son is diagnosed with a serious mental illness and has spent time in-patient at the Arizona State Mental Hospital.  As a Mom with a son who had a serious mental illness, I certainly can understand her motivation to try and make a difference.  Stigma continues to be pervasive and some still believe it’s the Mother’s fault when a mental illness presents itself.  Character flaws, laziness, and violent behavior automatically get labeled as mental illnesses when medical science knows that these illnesses are actual biological brain disorders that are treatable.  With proper medical treatment and support people have and do live in recovery.

Given all the positive news about the potential for recovery, why in the world has Govenor Brewer decided to not only distance herself from the issues, but supported drastic slashes to budgets that assist people with mental illness?  I understand that we need to cut our spending, but why cut spending for our state’s most vulnerable?  In the long run, as Gov. Brewer knows, we will end up spending more for emergency room visits, hospitalizations and incarcerations for ignored people living with a treatable mental illness.  With all the publicity and nation wide visability she has created over the last several months, it seems a shame to me that she hasn’t used the opportunity to advance anti-stigma and the value of  proper treatment to some of our states most vulnerable…….including her son.  Is the illegal immigraton bandwagon the only issue she can focus on now?

The law included a six month extension of higher Medicaid federal matching funds for states – a major contribution towards some of the drastic slashes in mental health coverage in Arizona.

Recent budget slashes (I prefer that term over cuts as I feel it’s much more descriptive) in the state’s healthcare system for the poor have forced many people to search for alternatives to afford their medications. Some are going to Canada, while some have been fortunate to be able to get discounts directly from the pharmaceutical companies. I applaud the efforts of some of the drug companies to help and I wish they would all step up.

While illegal immigration and calls to enforce the border by sending in troops occupies the headlines, our state’s most vulnerable citizens are doing the best they can just to survive.  In my world they take priority over someone who has illegally crossed our borders to look for a better way of life.  Helping disabled and seriously mentally ill people is not only money well spent, it’s the “right” thing to do!

How Did Your Member Vote?

View the House roll call vote on final passage of HR 1586

Both McCain and Kyle voted no when the bill went through the senate.

Read further details on the provisions in HR 1586 designed to support state Medicaid programs into 2011.

Some have struggled for years to find the right medication “cocktail” and now the rug is being pulled out from under them. They won’t be able to afford the newer, more effective drugs that can cost thousands of dollars a month and they won’t have a therapist or case manager monitoring their changes.  Many are the “working poor” who make just a few too many dollars to qualify for the the state’s medicaid system, AHCCCS;  also  in jeopardy of loosing millions.

Yes, it looks like it could get even worse since  Congress may not extend the states Medicaid assistance. Medicaid assistance from the federal government was voted against by the U.S. Senate last week.  Without it, Arizona’s health care budget falls further into the red.  In a letter to Arizona members of Congress, Governor Brewer complained that “(I)t has become clear that Congress does not have the will to assist states in addressing the very problem that it created.” Based on her combative attitude displayed recently all over the media, I will be surprised if any “Fed” will pay attention.

I guess you can tell I’m angry, but instead of complaining, I wish she would use the same “take charge” attitude towards our state’s health care system as she does toward our illegal immigration issues where no expense spared is the mantra.  We’re soon to be using our local city and state law enforcement officers to enforce federal immigration laws.  Plus, there always seems to be more money to build more prisons to house the additional “illegal immigrants.”  What about using money to house and treat some of our state’s most vulnerable citizens?

The Obama administration launched a new health care reform website yesterday that provides information to the public on “the full range of public and private health insurance plans” that fits their specific circumstances. Mandated by the health reform law, the site will show users how their options “will change in coming years” as the law takes effect. – The Progress Report, July 1, 2010

But, this catastrophic Gulf oil spill has gotten me down.  I can’t imagine what it must be like for people who live in the area affected. And that area is growing day by day.  If you listen to some doomsday “sayers” this is just the beginning of a global crisis that could change the world as we know it. One can’t help but get nostalgic thinking about the days most of us have spent frolicking on white sand and splashing in the ocean. Some of my favorite childhood memories are from family vacations spent on the beach.  Many times it was on a Gulf of Mexico beach.  Same is true for my daughter, except that it was usually the Sea of Cortez.

What I can say for a fact is that the Gulf of Mexico is experiencing the biggest threat to it’s environment in history and it makes me want to cry.  When I first heard of the oil spill, I had this sinking feeling in my stomach.  Some how I knew intuitively this wasn’t just another oil spill. Now, almost two months later most of the world knows it’s the worst environmental disaster in history.  Scary part is, we still don’t know how to stop it.

A few facts we do know:

• 11 people lost their lives in the initial explosion
• Efforts to cap it or plug it have been unsuccessful
• Relief well may or may not work
• Dispersant’s being used are toxic
• Skimming works in a very small area
• Small portion of the oil is being recaptured
• Thousands of people’s livelihoods have been disrupted

No one really knows how this will end. President Obama said in his speech on Tuesday that we should all pray.  Some made fun of that suggestion.  It reminded me of the bumper stickers that say “Visualize Peace,”  or the adage “the power of positive thinking.”  So,  I think we should all visualize a clean Gulf – it can’t hurt! Thinking about a clean beach and aqua blue seas can definitely lighten my mood!!

NAMI Southern Arizona and Community Partnership of Southern Arizona (CPSA) are co-hosting this meeting to help answer your questions about the recent changes to CPSA’s system of care.

If you are not currently on AHCCCS (Medicaid, Title XIX), staff experienced in determining AHCCCS eligibility will be at the meeting.
A Community Resource List will also be distributed with contact information for a variety of services offered throughout Pima County.
Space is limited. RSVP Required by Monday, June 7th
Call 784-5378
(Spanish translation is available upon request)